This Doctor is Great

Zhou Mo didn't expect that he just posted a paper, and then the paper micro-business came to the door.

Many doctors have to buy papers in order to evaluate the chief physician and deputy director, but their own strength is not enough.

Is this also a 'unspoken rule'?

As for the people in the department, do they know that he bought the paper?

If you buy a paper that is not related to your major, or if you spend all day looking for fish and stocks, but the paper continues to be rated as the chief and deputy director, then there is a high possibility.

Although Zhou Mo is greedy for the price and income in this area, but after thinking about it, he should be safe and not be greedy for this kind of money.

"Little Mo..."

At this moment, Mr. Huang Li walked quickly into the duty room.

"Teacher, what's wrong?"

"There is a consultation in the emergency room, are you interested?"

Have a consultation? If you say that, I won't be sleepy!

"Of course I'm interested, thank you teacher!" Zhou Mo said quickly.

"Teacher, I want to go too." Huang Yiming next to him looked shyly at Mr. Huang Li with a look of anticipation.

Huang Li was also satisfied with Huang Yiming's recent performance, he waved his hand: "Okay, you will come too."

"okay!"

Huang Yiming jumped up happily.

The three quickly left the duty room, leaving behind five medical students who were envious and drooling.

The emergency department pretends to be coercive... ah no, consultation, I want to go too!

…

Emergency Department.

After Huang Li, Zhou Mo, and Huang Yiming stepped into the emergency department, they felt like entering the vegetable market.

There are queue-jumping, cursing, and children crying...

"We are from the Department of Cardiology, and we were just notified to come for a consultation!"

"emergency room."

The nurse at the nurse station said quickly.

The three walked quickly to the emergency room.

Huang Yiming is very excited, I must perform well in the future, and then amaze everyone!

I am Huang Yiming, I will never lose to others in my life.jpg

into the emergency room,

There are many beds in the emergency room, and several patients are lying there.

"Cardiology consultation!" Zhou Mo shouted.

"Here..." the doctor in one of the beds shouted.

Huang Li and Zhou Mo walked over quickly.

As Zhou Mo walked, he observed the patient on the bed.

About sixty or seventy years old,

Female,

There are many wrinkles, as well as a lot of white hair and age spots.

The old man was in a coma and was intubated on a ventilator, but his face was pale.

Zhou Mo glanced at the ECG monitor beside the bed.

Blood oxygen 68.

160/90mmHg.

Heart rate 132 beats/min.

"???"

Using intubation ventilation, only 68?

Blood pressure and heart rate are working hard, why is blood oxygen so low?

Have a heart problem?

No,

It's not the heart, it should be a problem with the itching process of the lungs!

Zhou Mo suddenly had a judgment in his heart.

"Mr. Huang!" The emergency doctor greeted Mr. Huang Li, and then couldn't help but glance at Zhou Mo and Huang Yiming.

Zhou Mo took a look, isn't this emergency doctor the same emergency senior who sent Mr. Liu this morning? What a coincidence.

Teacher Huang Li observed the patient and asked, "What's the condition of the patient now?"

The senior in the emergency department stroked it and said quickly: "It's like this, two days ago, the patient suddenly felt a little difficult to breathe and felt chest tightness. After two days, he couldn't stand it, and then he came to our hospital about an hour ago and wanted to go to the hospital. Respiratory clinic, and finally came to the emergency room."

"When the patient came in, her lips were cyanotic, her hands and feet were cold, and her face was pale. It was a sign of hypoxia, so she was given non-invasive breathing."

"But just when I wanted to examine her, the old man suddenly fell down..."

"I couldn't wake up no matter how I called, my heart stopped!"

"Then we rescued, cardiopulmonary resuscitation, ventilator tracheal intubation..."

"Finally, at 15 minutes, the rescue came back."

This senior in the emergency department is more ink-stained.

After listening patiently, Mr. Huang Li asked, "Have you asked about the medical history?"

Senior Brother from the emergency department: "I asked, I have no high blood pressure, no diabetes, no high blood lipids, and I felt short of breath and suffocation 3 days ago."

Zhou Mo listened carefully beside him.

Short of breath 3 days ago?

This shows that the illness has been more than 3 days.

There are many reasons for shortness of breath, heart problems, lung problems, muscle weakness, etc…

Zhou Mo was right next to the bed, and he couldn't help but pulled the patient's arm. The resistance was quite strong, not like muscle weakness.

So focus on the heart and lungs.

For emergency patients, the first thing to do is to rule out more dangerous diseases.

Myocardial infarction, pulmonary embolism, pneumothorax…

Also consider pneumonia...

The emergency senior brought out some test results.

"This is an electrocardiogram... twice, I went to the emergency room once, just once..."

Received an electrocardiogram.

Huang Li and Zhou Mo began to watch, and Huang Yiming stretched his neck and watched.

Obviously, the two ECGs did not indicate myocardial infarction!

Excluded: myocardial infarction.

Pneumothorax? ?

Zhou Mo took the stethoscope and began to listen to the patient's lungs.

Upon hearing it,

Perfectly symmetrical, no problem.

Not a pneumothorax.

As I wrote earlier, pneumothorax, in common terms, is when the lungs are broken, and the gas in the alveoli enters the chest cavity, which in turn compresses the lungs, causing difficulty in breathing!

If there is a pneumothorax, it must be asymmetrical. Unless there is a very small probability of pneumothorax on both sides, and the size and location of the pneumothorax are the same.

Excluded: myocardial infarction, pneumothorax.

Severe pneumonia and pulmonary embolism should be ruled out.

Teacher Huang Li: "Does the patient have symptoms such as cough, expectoration, and fever?"

Cough is because the lungs are uncomfortable, so the human body has to cough it out.

expectoration, phlegm is an inflamed secretion, which is definitely uncomfortable in the lungs, so there will be a conditioned reflex to expectoration.

Fever, the lungs are inflamed, the human body begins to make an immune resistance response, the body temperature rises, and naturally a fever occurs.

As long as it is pneumonia, there are basically symptoms of cough, sputum, and fever.

The emergency senior brother shook his head: "I have asked my family, but I don't have any of these symptoms."

Teacher Huang Li: "Have you drawn blood? Have the results come out?"

"Not yet... I'll take a look now..."

The emergency elder brother picked up the ipad, UU read the book www.uukanshu. com to check whether the patient's information has been returned.

"Hey, it's out."

"let me see."

"C-reactive protein is only 4.3...no inflammation..."

Serum C-reactive protein is a sensitive indicator reflecting various infections and non-infectious inflammations in the body, and is a non-specific marker of systemic inflammation.

Its accuracy is higher than that of blood routine indicators such as white blood cells.

so,

Pneumonia can be ruled out.

Then, the next step is to rule out pulmonary embolism.

Pulmonary embolism is a very serious emergency. Every extra minute delay brings the patient one step closer to death.

Moreover, Zhou Mo, combined with the patient's low blood oxygen, concluded that the patient was a pulmonary embolism!

Teacher Huang Li: "Have you checked blood coagulation indicators?"

Emergency senior brother: "No."

Teacher Huang Li: "Sampling now, now checking...and D-dimer, and then an arterial blood gas analysis..."

Emergency senior: "Yes!"

Immediately ask the nurse to draw blood...

at this time,

Zhou Mo has already pulled open the patient's trouser legs.

Varicose veins!

I saw the patient's old man's legs, many circling blue veins.

Zhou Mo: "There seems to be a bedside color Doppler ultrasound in the emergency room, right? Can you push it for me?"

The emergency senior brother raised his head and looked at Zhou Mo.

Amazed.

"Can you use it?"

Huang Yiming tilted his head back subconsciously.

Hmph, let you see the strength of Mexico in the emergency room!

.